Jo Anne Zujewski, MD Jo Anne Zujewski, MD Cancer Therapy Evaluation Program Cancer Therapy Evaluation Program Division of Cancer Diagnosis and Division of Cancer Diagnosis and Treatment Treatment National Cancer Institute National Cancer Institute January 2011 January 2011 www.bhgi.info
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Jo Anne Zujewski, MD Cancer Therapy Evaluation Program Division of Cancer Diagnosis and Treatment National Cancer Institute January 2011 .
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Jo Anne Zujewski, MDJo Anne Zujewski, MDCancer Therapy Evaluation ProgramCancer Therapy Evaluation Program
Division of Cancer Diagnosis and TreatmentDivision of Cancer Diagnosis and TreatmentNational Cancer InstituteNational Cancer Institute
WORLD BANK COUNTRY GROUPS WORLD BANK COUNTRY GROUPS WORLD BANK CLASSIFICATION (ATLAS METHOD)WORLD BANK CLASSIFICATION (ATLAS METHOD)
World Bank Country Groups(GNI per capita)
Low Income
($995 or less)
LowerMiddle Income
($996 - $3,945)
UpperMiddle Income($3,946 - $12,195)
High Income
($12,196 or more)
Average female life expectancy at birth 57.8 yrs 69.3 yrs 74.4 yrs 82.4 yrs
Average GNI per capita (2009 US dollars) $403 $1,723 $6,314 $36,953
Total national health expenditure per capita $22 $76 $458 $4,266
Fraction of GDP spent on health care 5.1% 4.3% 6.4% 11.2%
Health expenditure figures 2010 for calendar year 2007; GNI = gross national income http://data.worldbank.org/data-catalog/health-nutrition-and-population-statistics.
The The Breast Health Global Initiative (BHGI)Breast Health Global Initiative (BHGI) strives to strives to develop, implement and study evidence-based, develop, implement and study evidence-based,
economically feasible, and culturally appropriate economically feasible, and culturally appropriate guidelines for international breast health and cancer guidelines for international breast health and cancer
control for low and middle income countries to control for low and middle income countries to improve breast health outcomes.improve breast health outcomes.
The The Breast Health Global Initiative (BHGI)Breast Health Global Initiative (BHGI) strives to strives to develop, implement and study evidence-based, develop, implement and study evidence-based,
economically feasible, and culturally appropriate economically feasible, and culturally appropriate guidelines for international breast health and cancer guidelines for international breast health and cancer
control for low and middle income countries to control for low and middle income countries to improve breast health outcomes.improve breast health outcomes.
GLOBAL SUMMIT 2005 – GLOBAL SUMMIT 2005 – BETHESDABETHESDA
RESOURCE STRATIFICATIONRESOURCE STRATIFICATION
Basic level: Basic level: Core resourcesCore resources or fundamental services or fundamental services necessary for any breast health care system to function. necessary for any breast health care system to function.
Limited level: Limited level: Second-tier resourcesSecond-tier resources or services that produce or services that produce major improvements in outcome such as survival.major improvements in outcome such as survival.
Enhanced level: Enhanced level: Third-tier resourcesThird-tier resources or services that are or services that are optional but important, because they increase the number optional but important, because they increase the number and quality of therapeutic options and patient choice. and quality of therapeutic options and patient choice.
Maximal level: Maximal level: Highest-level resourcesHighest-level resources or services used in or services used in some high resource countries that have some high resource countries that have lower priority lower priority on the on the basis of extreme cost and/or impracticality.basis of extreme cost and/or impracticality.
Executive Summary: Lancet Oncology, 12: in press, 2011Executive Summary: Lancet Oncology, 12: in press, 2011Consensus Supplement: The Breast, in press, 2011Consensus Supplement: The Breast, in press, 2011
GLOBAL SUMMIT 2010 – GLOBAL SUMMIT 2010 – CHICAGOCHICAGO
GLOBAL SUMMIT 2010 – GLOBAL SUMMIT 2010 – CHICAGOCHICAGO
OPTIMIZING DELIVERYOPTIMIZING DELIVERY Cancer registries Cancer registries for prevalence , stage, and for prevalence , stage, and
outcomeoutcome National cancer plans define National cancer plans define cancer care networkscancer care networks Multidisciplinary care Multidisciplinary care to avoid fragmentationto avoid fragmentation issuesissues
Lancet Oncology, 12: in press, 2011Lancet Oncology, 12: in press, 2011
OPTIMIZING DELIVERYOPTIMIZING DELIVERY
TrainingTraining linked to equipment linked to equipment acquisition / quality careacquisition / quality care
Public awareness programsPublic awareness programs linked to linked to early detectionearly detection
Clinical breast examination Clinical breast examination (CBE) (CBE) promotionpromotion
CoordinationCoordination of diagnosis and of diagnosis and treatmenttreatment
SOUTH + CENTRAL AMERICA ESTIMATES 2008: SOUTH + CENTRAL AMERICA ESTIMATES 2008: 105,900 cases; 33,600 deaths105,900 cases; 33,600 deaths
0.37 0.36
0.30
BHGI GLOBAL ALLIANCEBHGI GLOBAL ALLIANCEBENEFACTOR / FOUNDATIONAL GRANTSBENEFACTOR / FOUNDATIONAL GRANTS• Susan G. Komen for the Cure® Susan G. Komen for the Cure® • European School of Oncology (ESO) European School of Oncology (ESO) • Pan American Health Organization (PAHO)Pan American Health Organization (PAHO)• Sheikh Mohammed Hussein Al-Amoudi Center of Sheikh Mohammed Hussein Al-Amoudi Center of
Excellence in Breast CancerExcellence in Breast Cancer• American Society of Clinical Oncology (ASCO)American Society of Clinical Oncology (ASCO)• LIVESTRONGLIVESTRONG
CORPORATE PARTNERSCORPORATE PARTNERS• GE HealthcareGE Healthcare• Sanofi-AventisSanofi-Aventis